Medicare xray for physician assistant along with visits

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Hi, i have a question, we have a physician assistant starting now when shes patients it will get billed under her, however, if she performs an xray we were told that it has to be billed under the provider is what i am told because medicare does not cover xrays for a physican assistant - my question is- how would they get paid for the xrays if they came in and saw the physican assistant? Any input will really help, thank you so much
 

mitchellde

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if Medicare is stating they do not cover x-ray performed by a PA then that is the answer. it is not covered and you cannot do anything to make it be covered. the only way you could bill it under the physician number would be if they allow x-rays to be billed incident-to (not all states will allow this) if so then the provider must be the one to initially see the patient and order the x-ray and be physically in the office at the time it is being performed. If you are planning to bill the patient then you must obtain an ABN for this service indicating that Medicare will not cover this service provided by this provider and have the patient sign it and use the GA modifier on the x-ray charge.
 

thomas7331

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Most x-rays are listed as have a supervision requirement of 'general', not 'direct' supervision. 'General' is defined as "furnished under the physician’s overall direction and control, but the physician’s presence is not required during the performance of the procedure. Under general supervision, the training of the nonphysician personnel who actually performs the diagnostic procedure and the maintenance of the necessary equipment and supplies are the continuing responsibility of the physician." So I'm not sure I understand how this service would fall under the 'incident to' rules - as I read this, the technical component of an x-ray could be billed under the physician who owns and is responsible for it without having them immediately present.
 

littlelora

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What about BWC? Would they follow the same guidelines? And Thomas, you're referring to the physician in the statement above saying to bill them with only the technical component, meaning the professional component would be billed by the PA, or no one?
 
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